Turkiye Klinikleri Journal of Health Sciences

.: REVIEW
Combined Use of Probiotics and Vitamin D Against Neurotoxicity: Traditional Review
Nörotoksisiteye Karşı Probiyotik ve D Vitamininin Birlikte Kullanımı: Geleneksel Derleme
Fatma Hazan GÜLa
aDepartment of Nutrition and Dietetics, Mersin University Faculty of Health Science, Mersin, Türkiye
Turkiye Klinikleri J Health Sci. 2024;9(1):210-6
doi: 10.5336/healthsci.2023-98902
Article Language: EN
Full Text
ABSTRACT
Neurodegeneration caused by neurotoxicity is a condition influenced by many factors such as increased reactive oxygen species, protein misfolding, and ubiquitin-proteasome pathway dysfunction. The brain-gut axis is one of the primary systems affected by neurodegeneration. This axis is a bidirectional system consisting of neurological, endocrine, and immunological elements. Disruption of microbial balance in the gut leads to poor inflammation, increased oxidative stress, disruption of energy homeostasis, and cellular degeneration. Probiotics, which are important for maintaining this balance, are beneficial bacteria that, when ingested in sufficient quantities, positively affect host health and play an active role in maintaining microbial homeostasis in the gut. Another substance that impacts neurodegeneration is vitamin D. It is clearly stated in the literature that vitamin D supplementation, a fat-soluble micronutrient that falls into the steroid hormone category, or adequate sun exposure positively reduces the risk of developing/progressing neurodegenerative disorders. Vitamin D achieves this effect by inhibiting the synthesis of nitric oxide synthase and increasing the stimulation of gamma-glutamyl transpeptidase. Moreover, vitamin D exerts this beneficial effect by binding to vitamin D receptors in the intestine. It is known that probiotics and vitamin D have separate neuroprotective effects against neurotoxicity, but it is not well enough known that their beneficial effects are enhanced when probiotics and vitamin D are taken together. The aim of this study is to show that the beneficial effects of probiotics and vitamin D against neurotoxicity are enhanced when they are taken together.

Keywords: Probiotics; vitamin D; microbiota; brain-gut axis; neurotoxicity syndromes
ÖZET
Nörotoksisitenin neden olduğu nörodejenerasyon, reaktif oksijen türlerinin artması, proteinlerin yanlış katlanması ve ubikitin-proteozom yolağının disfonksiyonu gibi birçok faktörden etkilenen bir durumdur. Nörojenerasyondan etkilenen sistemlerin başında beyin-bağırsak aksı gelir. Bu aks nörolojik, endokrin ve immünolojik unsurlardan oluşan çift yönlü bir sistemdir. Bağırsağın mikrobiyal dengesinin bozulması düşük dereceli inflamasyona, oksidatif streste artışa, enerji homeostazının bozulmasına ve hücresel dejenerasyonun artmasına neden olur. Bu dengenin korunmasında önemli olan probiyotikler, yeterli miktarda alındığında konakçı sağlığını olumlu yönde etkileyen ve bağırsaklarda mikrobiyal homeostazın sağlanmasında aktif rol oynayan yararlı bakterilerdir. Nörodejenerasyon üzerine etkisi olduğu bilinen bir diğer madde D vitaminidir. Steroid hormon kategorisine giren ve yağda çözünen bir mikro besin olan D vitamini takviyesinin veya yeterli güneş ışığına maruz kalmanın, nörodejeneratif bozuklukların gelişme/ilerleme riskini olumlu yönde azalttığı literatürde açıkça belirtilmektedir. D vitamini bu etkisini nitrik oksit sentazın sentezini inhibe ederek ve gama-glutamil transpeptidazın stimülasyonunu artırarak gerçekleştirmektedir. Ayrıca D vitamini bu yararlı etkisini bağırsaktaki D vitamini reseptörlerine bağlanarak gösterir. Probiyotikler ve D vitamininin nörotoksisiteye karşı ayrı ayrı nöroprotektif etkisi olduğu bilinmekle birlikte, probiyotikler ve D vitamini birlikte alındığında bu protektif etkinin arttığı yeterince bilinmemektedir. Bu çalışmanın amacı, nörotoksisiteye karşı probiyotiklerin ve D vitamininin birlikte kullanıldığında yararlı etkilerinin artığını ortaya koymaktır.

Anahtar Kelimeler: Probiyotikler; D vitamini; mikrobiyota; beyin-bağırsak aksı; nörotoksisite sendromları
REFERENCES:
  1. Lopez-Suarez L, Awabdh SA, Coumoul X, Chauvet C. The SH-SY5Y human neuroblastoma cell line, a relevant in vitro cell model for investigating neurotoxicology in human: Focus on organic pollutants. Neurotoxicology. 2022;92:131-55. [Crossref]  [PubMed] 
  2. Grandjean P, Landrigan PJ. Developmental neurotoxicity of industrial chemicals. Lancet. 2006;368(9553):2167-78. [Crossref]  [PubMed] 
  3. Grandjean P, Landrigan PJ. Neurobehavioural effects of developmental toxicity. Lancet Neurol. 2014;13(3):330-8. [Crossref]  [PubMed]  [PMC] 
  4. Tseng CY. Effects of atypical neurotoxins on the developing fetal brain. In: Erkekoglu P, Ogawa T, eds. Medical Toxicology. 1st ed. United Kingdom: IntechOpen; 2021. [Link] 
  5. Abdel-Aal RA, Assi AA, Kostandy BB. Memantine prevents aluminum-induced cognitive deficit in rats. Behav Brain Res. 2011;225(1):31-8. [Crossref]  [PubMed] 
  6. Eiser AR. Why does Finland have the highest dementia mortality rate? Environmental factors may be generalizable. Brain Res. 2017;1671:14-7. [Crossref]  [PubMed] 
  7. Zádori D, Klivényi P, Szalárdy L, Fülöp F, Toldi J, Vécsei L. Mitochondrial disturbances, excitotoxicity, neuroinflammation and kynurenines: novel therapeutic strategies for neurodegenerative disorders. J Neurol Sci. 2012;322(1-2):187-91. [Crossref]  [PubMed] 
  8. Hardingham N, Dachtler J, Fox K. The role of nitric oxide in pre-synaptic plasticity and homeostasis. Front Cell Neurosci. 2013;7:190. [Crossref]  [PubMed]  [PMC] 
  9. Kim YH, Sol IS, Yoon SH, Kim MJ, Kim KW, Sohn MH, et al. Association of extended nitric oxide parameters with bronchial hyperresponsiveness and bronchodilator response in children with asthma. J Breath Res. 2017;11(4):046003. [Crossref]  [PubMed] 
  10. Kumar P, Kalonia H, Kumar A. Cyclosporine A attenuates 3-nitropropionic acid-induced Huntington-like symptoms in rats: possible nitric oxide mechanism. Int J Toxicol. 2010;29(3):318-25. [Crossref]  [PubMed] 
  11. Nasyrova RF, Ivashchenko DV, Ivanov MV, Neznanov NG. Role of nitric oxide and related molecules in schizophrenia pathogenesis: biochemical, genetic and clinical aspects. Front Physiol. 2015;6:139. [Crossref]  [PubMed]  [PMC] 
  12. Rönnbäck C, Hansson E. The importance and control of low-grade inflammation due to damage of cellular barrier systems that may lead to systemic inflammation. Front Neurol. 2019;10:533. [Crossref]  [PubMed]  [PMC] 
  13. Ghose AK, Herbertz T, Hudkins RL, Dorsey BD, Mallamo JP. Knowledge-Based, Central Nervous System (CNS) lead selection and lead optimization for CNS drug discovery. ACS Chem Neurosci. 2012;3(1):50-68. [Crossref]  [PubMed]  [PMC] 
  14. Zhu X, Liu X, Wei F, Wang F, Merzenich MM, Schreiner CE, et al. Perceptual training restores impaired cortical temporal processing due to lead exposure. Cereb Cortex. 2016;26(1):334-45. [Crossref]  [PubMed]  [PMC] 
  15. Hassel B. Tetanus: pathophysiology, treatment, and the possibility of using botulinum toxin against tetanus-induced rigidity and spasms. Toxins (Basel). 2013;5(1):73-83. [Crossref]  [PubMed]  [PMC] 
  16. Chulanetra M, Bangphoomi K, Sookrung N, Thanongsaksrikul J, Srimanote P, Sakolvarvaree Y, et al. Human ScFv that block sodium ion channel activity of tetrodotoxin. Toxicon. 2012;59(2):272-82. [Crossref]  [PubMed] 
  17. Huang W, Booth DM, Cane MC, Chvanov M, Javed MA, Elliott VL, et al. Fatty acid ethyl ester synthase inhibition ameliorates ethanol-induced Ca2+-dependent mitochondrial dysfunction and acute pancreatitis. Gut. 2014;63(8):1313-24. [Crossref]  [PubMed]  [PMC] 
  18. Kiecker C. The chick embryo as a model for the effects of prenatal exposure to alcohol on craniofacial development. Dev Biol. 2016;415(2):314-25. [Crossref]  [PubMed] 
  19. Luo J. Autophagy and ethanol neurotoxicity. Autophagy. 2014;10(12):2099-108. [Crossref]  [PubMed]  [PMC] 
  20. Roux A, Jackson SN, Muller L, Barbacci D, O'Rourke J, Thanos PK, et al. Ethanol induced brain lipid changes in mice assessed by mass spectrometry. ACS Chem Neurosci. 2016;7(8):1148-56. [Crossref]  [PubMed]  [PMC] 
  21. Scott KP, Antoine JM, Midtvedt T, van Hemert S. Manipulating the gut microbiota to maintain health and treat disease. Microb Ecol Health Dis. 2015;26:25877. [Crossref]  [PubMed]  [PMC] 
  22. EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP); Rychen G, Aquilina G, Azimonti G, Bampidis V, Bastos ML, Bories G, et al. Guidance on the characterisation of microorganisms used as feed additives or as production organisms. EFSA J. 2018;16(3):e05206. [Crossref]  [PubMed]  [PMC] 
  23. Lee SHF, Ahmad SR, Lim YC, Zulkipli IN. The use of probiotic therapy in metabolic and neurological diseases. Front Nutr. 2022;9:887019. [Crossref]  [PubMed]  [PMC] 
  24. Michael DR, Davies TS, Loxley KE, Allen MD, Good MA, Hughes TR, et al. In vitro neuroprotective activities of two distinct probiotic consortia. Benef Microbes. 2019;10(4):437-47. [Crossref]  [PubMed] 
  25. Cheng B, Lu H, Bai B, Chen J. d-β-Hydroxybutyrate inhibited the apoptosis of PC12 cells induced by H2O2 via inhibiting oxidative stress. Neurochem Int. 2013;62(5):620-5. [Crossref]  [PubMed] 
  26. Xie HR, Hu LS, Li GY. SH-SY5Y human neuroblastoma cell line: in vitro cell model of dopaminergic neurons in Parkinson's disease. Chin Med J (Engl). 2010;123(8):1086-92. [PubMed] 
  27. Cheon MJ, Lim SM, Lee NK, Paik HD. Probiotic Properties and Neuroprotective Effects of Lactobacillus buchneri KU200793 Isolated from Korean Fermented Foods. Int J Mol Sci. 2020;21(4):1227. [Crossref]  [PubMed]  [PMC] 
  28. Cheon MJ, Lee NK, Paik HD. Neuroprotective effects of heat-killed lactobacillus plantarum 200655 isolated from kimchi against oxidative stress. Probiotics Antimicrob Proteins. 2021;13(3):788-95. [Crossref]  [PubMed] 
  29. Park J, Lee J, Yeom Z, Heo D, Lim YH. Neuroprotective effect of Ruminococcus albus on oxidatively stressed SH-SY5Y cells and animals. Sci Rep. 2017;7(1):14520. [Crossref]  [PubMed]  [PMC] 
  30. Distrutti E, O'Reilly JA, McDonald C, Cipriani S, Renga B, Lynch MA, et al. Modulation of intestinal microbiota by the probiotic VSL#3 resets brain gene expression and ameliorates the age-related deficit in LTP. PLoS One. 2014;9(9):e106503. [Crossref]  [PubMed]  [PMC] 
  31. Nicola S, Amoruso A, Deidda F, Pane M, Allesina S, Mogna L, et al. Searching for the Perfect Homeostasis: Five Strains of Bifidobacterium longum From Centenarians Have a Similar Behavior in the Production of Cytokines. J Clin Gastroenterol. 2016 Nov/Dec;50 Suppl 2, Proceedings from the 8th Probiotics, Prebiotics & New Foods for Microbiota and Human Health meeting held in Rome, Italy on September 13-15, 2015:S126-S130. [Crossref]  [PubMed] 
  32. Nowak A, Paliwoda A, Błasiak J. Anti-proliferative, pro-apoptotic and anti-oxidative activity of Lactobacillus and Bifidobacterium strains: A review of mechanisms and therapeutic perspectives. Crit Rev Food Sci Nutr. 2019;59(21):3456-67. [Crossref]  [PubMed] 
  33. Castelli V, d'Angelo M, Lombardi F, Alfonsetti M, Antonosante A, Catanesi M, et al. Effects of the probiotic formulation SLAB51 in in vitro and in vivo Parkinson's disease models. Aging (Albany NY). 2020;12(5):4641-49. [Crossref]  [PubMed]  [PMC] 
  34. Bikle DD. Vitamin D metabolism, mechanism of action, and clinical applications. Chem Biol. 2014;21(3):319-29. [Crossref]  [PubMed]  [PMC] 
  35. Mokhtari Z, Hekmatdoost A, Nourian M. Antioxidant efficacy of vitamin D. J Parathyr Dis. 2016;5(1):11-6. [Link] 
  36. van Schoor N, Lips P. Global overview of vitamin D status. Endocrinol Metab Clin North Am. 2017;46(4):845-70. [Crossref]  [PubMed] 
  37. Khazai N, Judd SE, Tangpricha V. Calcium and vitamin D: skeletal and extraskeletal health. Curr Rheumatol Rep. 2008;10(2):110-7. [Crossref]  [PubMed]  [PMC] 
  38. Reid IR, Bolland MJ, Grey A. Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis. Lancet. 2014;383(9912):146-55. [Crossref]  [PubMed] 
  39. Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in autoimmunity: molecular mechanisms and therapeutic potential. Front Immunol. 2017;7:697. [Crossref]  [PubMed]  [PMC] 
  40. Jang W, Kim HJ, Li H, Jo KD, Lee MK, Song SH, et al. 1,25-Dyhydroxyvitamin D₃ attenuates rotenone-induced neurotoxicity in SH-SY5Y cells through induction of autophagy. Biochem Biophys Res Commun. 2014;451(1):142-7. [Crossref]  [PubMed] 
  41. Chen L, Zhou K, Chen H, Li S, Lin D, Zhou D. Calcitriol promotes survival of experimental random pattern flap via activation of autophagy. Am J Transl Res. 2017;9(8):3642-53. [PubMed]  [PMC] 
  42. Smith MP, Fletcher-Turner A, Yurek DM, Cass WA. Calcitriol protection against dopamine loss induced by intracerebroventricular administration of 6-hydroxydopamine. Neurochem Res. 2006;31(4):533-9. [Crossref]  [PubMed] 
  43. Wang JY, Wu JN, Cherng TL, Hoffer BJ, Chen HH, Borlongan CV, et al. Vitamin D(3) attenuates 6-hydroxydopamine-induced neurotoxicity in rats. Brain Res. 2001;904(1):67-75. [Crossref]  [PubMed] 
  44. Bashir M, Prietl B, Tauschmann M, Mautner SI, Kump PK, Treiber G, et al. Effects of high doses of vitamin D3 on mucosa-associated gut microbiome vary between regions of the human gastrointestinal tract. Eur J Nutr. 2016;55(4):1479-89. [Crossref]  [PubMed]  [PMC] 
  45. Biesalski HK. Nutrition meets the microbiome: micronutrients and the microbiota. Ann N Y Acad Sci. 2016;1372(1):53-64. [Crossref]  [PubMed] 
  46. Ly NP, Litonjua A, Gold DR, Celedón JC. Gut microbiota, probiotics, and vitamin D: interrelated exposures influencing allergy, asthma, and obesity? J Allergy Clin Immunol. 2011;127(5):1087-94; quiz 1095-6. [Crossref]  [PubMed]  [PMC] 
  47. Shah C, Mokashe N, Mishra V. Preparation, characterization and in vitro antioxidative potential of synbiotic fermented dairy products. J Food Sci Technol. 2016;53(4):1984-92. [Crossref]  [PubMed]  [PMC] 
  48. Battistini C, Nassani N, Saad SM, Sun J. Probiotics, vitamin D, and vitamin D receptor in health and disease. In: de Albuquerque MAC, de LeBlanc AM, LeBlanc JG, Bedani R, eds. Lactic Acid Bacteria A Functional Approach. 1st ed. Boca Raton: CRC Press; 2020. p.93-105. [Crossref] 
  49. Ogbu D, Xia E, Sun J. Gut instincts: vitamin D/vitamin D receptor and microbiome in neurodevelopment disorders. Open Biol. 2020;10(7):200063. [Crossref]  [PubMed]  [PMC] 
  50. Ghaderi A, Banafshe HR, Mirhosseini N, Moradi M, Karimi MA, Mehrzad F, et al. Clinical and metabolic response to vitamin D plus probiotic in schizophrenia patients. BMC Psychiatry. 2019;19(1):77. [Crossref]  [PubMed]  [PMC] 
  51. Raygan F, Ostadmohammadi V, Bahmani F, Asemi Z. The effects of vitamin D and probiotic co-supplementation on mental health parameters and metabolic status in type 2 diabetic patients with coronary heart disease: A randomized, double-blind, placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):50-5. [Crossref]  [PubMed] 
  52. Kılınç GE. Obez ratlarda probiyotik ile D vitamini takviyesinin bağırsak mikrobiyotası ve D vitamini reseptör kompozisyonu üzerine etkilerinin deneysel olarak araştırılması [Yüksek lisans tezi]. Samsun: Ondokuz Mayıs Üniversitesi; 2018. Erişim tarihi: 18.07.2023. Erişim linki: [Link] 
  53. Jamilian M, Amirani E, Asemi Z. The effects of vitamin D and probiotic co-supplementation on glucose homeostasis, inflammation, oxidative stress and pregnancy outcomes in gestational diabetes: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2019;38(5):2098-105. [Crossref]  [PubMed] 
  54. Miraglia Del Giudice M, Maiello N, Allegorico A, Iavarazzo L, Capasso M, Capristo C, et al. Lactobacillus reuteri DSM 17938 plus vitamin D3 as ancillary treatment in allergic children with asthma. Ann Allergy Asthma Immunol. 2016;117(6):710-2. [Crossref]  [PubMed] 
  55. Ostadmohammadi V, Jamilian M, Bahmani F, Asemi Z. Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome. J Ovarian Res. 2019;12(1):5. [Crossref]  [PubMed]  [PMC] 
  56. Tazzyman S, Richards N, Trueman AR, Evans AL, Grant VA, Garaiova I, et al. Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: outcomes from a pilot trial. BMJ Open Gastroenterol. 2015;2(1):e000052. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com